How disabling is depression? Evidence from a primary care sample

Abstract

Background. Major depression is an illness with a high prevalence and is most commonly seen and treated by general practitioners (GPs). Aim. To determine the level of disability in depressed patients seen in a primary care setting, and to investigate whether the level of disability was associated with the severity of the depression. Method: Prospective data collection, using the 36-item Shortened Form (SF-36), from the Medical Outcomes Study, as a measure of disability, and from the Beck Depression Inventory (BDI) in a sample of depressed patients recruited from a Counselling versus Antidepressant in Primary Care (CAPC) study in the Trent Region. All patients met the research diagnostic criteria for major depression. Results. Two hundred and fifty patients were assessed. These patients reported high levels of disability compared both with published norms and with other chronic physical illnesses. Increases in disability were especially noticeable in the domains of the SF-36 that were specific to mental illness. There was a significant correlation between scores on the SF-36 and the BDI. Conclusion. This study confirms that depressed patients in primary care report high levels of disability on the SF-36, and that the instrument is both specific to the domains expected to be affected by mental disorder and is sensitive to the severity of mood disturbance.